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360° 环扎视网膜切开术治疗复杂性视网膜脱离。

360° retinectomy for the treatment of complex retinal detachment.

机构信息

Institute of Ophthalmology and Visual Science-New Jersey Medical School, Newark, New Jersey, USA.

出版信息

Retina. 2011 Feb;31(2):266-74. doi: 10.1097/IAE.0b013e3181eef2c7.

DOI:10.1097/IAE.0b013e3181eef2c7
PMID:21124255
Abstract

PURPOSE

To review the anatomical and functional outcomes of eyes that underwent 360° retinectomy for a variety of indications and compare them with previously published results.

METHODS

Retrospective case series. We reviewed the data of 40 patients (41 eyes) who underwent pars plana vitrectomy and 360° retinectomy. The principal indication for surgery in this series was retinal detachment after penetrating trauma (26 of 41 eyes [63%]). Anatomical success was defined as complete retinal reattachment or attachment posterior to the scleral buckle, if present.

RESULTS

Thirty of the 41 eyes (73%) had follow-up of at least 6 months after 360° retinectomy, and of these, 11 eyes (37%) had recurrent retinal detachment. Seven of the latter eyes underwent repeat pars plana vitrectomy with anatomical success in 6 eyes (86%). Overall, anatomical success was achieved in 25 of 30 eyes (83%) with follow-up of ≥ 6 months after ≥ 1 operations (including 360° retinectomy). Visual results were limited with only 4 of 35 eyes (11%) in which visual acuity could be tested achieving ambulatory vision, which may reflect the preponderance of posttraumatic retinal detachments in this series.

CONCLUSION

The anatomical results of this series are comparable with those in the reported literature and indicate that vitrectomy with 360° retinectomy can be beneficial in the management of complex retinal detachments in otherwise unsalvageable eyes.

摘要

目的

回顾因各种适应证行 360°环扎视网膜切除术的眼的解剖和功能结果,并与既往发表的结果进行比较。

方法

回顾性病例系列研究。我们回顾了 40 例(41 只眼)接受经睫状体平坦部玻璃体切除术和 360°环扎视网膜切除术患者的资料。本系列手术的主要适应证为穿透性眼外伤后视网膜脱离(41 只眼中的 26 只[63%])。解剖成功定义为完全视网膜复位或巩膜扣带后视网膜附着,如果存在巩膜扣带的话。

结果

41 只眼中的 30 只(73%)在 360°环扎视网膜切除术后至少 6 个月进行了随访,其中 11 只眼(37%)出现复发性视网膜脱离。后者的 7 只眼接受了重复经睫状体平坦部玻璃体切除术,其中 6 只眼(86%)解剖成功。总的来说,在≥ 1 次手术(包括 360°环扎视网膜切除术)后至少 6 个月进行随访的 30 只眼中,有 25 只眼(83%)达到解剖成功。视力结果有限,在可测试视力的 35 只眼中,只有 4 只眼(11%)达到了可走动的视力,这可能反映了本系列中创伤后视网膜脱离的优势。

结论

本系列的解剖学结果与文献报道的结果相当,表明玻璃体切除术联合 360°环扎视网膜切除术对其他无法挽救的复杂视网膜脱离的治疗可能有益。

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